| NPI | 1548446909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: FL TRN11995) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2025-002) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2026-01-27 |